I'm Pharmacy: Don’t stockpile your medication, talk to your pharmacist about your health

By: Zubin Austin
published March 30, 2020 via Toronto Star

These are difficult times. Those of us with chronic medical conditions who rely on medications are deeply concerned about COVID-19. Forget toilet paper. What if my pharmacy runs out of medications?

Drug shortages were a reality of life long before COVID-19, and the causes are multi-fold: supply problems, manufacturing issues, and contracting issues. Today there is fourth cause: stockpiling.

Supply-related causes include insufficient access to raw materials, contamination or quality assurance issues, or transportation issues that prevent manufacturers from producing the final pharmaceutical product that patients rely on.

Manufacturing issues include changes in labelling or regulatory requirements that require retooling of production lines, local business-related issues, or technical problems affecting a production line.

Contracting issues can refer to changes in the ways that drug benefits plans pay for medications or select them to be eligible for reimbursement on a formulary; once drugs are delisted from a formulary, manufacturers may have little choice to but to discontinue production, thereby reducing diversity in the supply chain for that medication and increasing future likelihood of a shortage.

In the last few weeks, stockpiling has become another factor. As we have seen with consumer products, such as hand sanitizer, current concerns regarding COVID-19 prompt some to hoard prescription medications.

When patients stockpile, the system cannot ramp up production quickly enough to compensate.

Pharmaceutical manufacturing is not an activity that can easily be turned on or off: it is a complex process involving sourcing and production of the highest quality raw materials, constant testing of materials and processes to ensure high quality, and strenuous requirements for storage and transportation. When patients stockpile, the system cannot ramp up production quickly enough to compensate.

Stockpiling is short-sighted in other ways: unused medications will expire and lose potency, drugs that are incorrectly stored will quickly deteriorate, and the presence of too many medications may encourage inappropriate overconsumption or lead to accidental ingestion by children or pets.

One of the most impactful changes made to help patients and the health care system cope with drug shortages has been the evolution of the pharmacist’s role.

One of the most impactful changes made to help patients and the health care system cope with drug shortages has been the evolution of the pharmacist’s role. Today, in most provinces across Canada, pharmacists can independently renew, modify, adapt, and in some cases prescribe medications without waiting for physician approval.

Pharmacies will remain open while other businesses close. Recently a very good friend called me to say his pharmacy had run out of an inhaler he has used for years to manage his asthma. We talked about his asthma control, and prescription options to replace his specific inhaler, about using over the counter medications (like antihistamines), and about ways to reduce triggers. These kinds of conversations should have occurred well before a COVID-19 induced run-on-the-pharmacy caused alarm.

Feeling alarmed by news headlines is understandable: the answer is not to hoard medications and deprive others. Instead, using this as an opportunity to connect with your pharmacist, learn more about your medications and your health. Reassuring yourself that there are alternatives and options may be the best medicine.